Case Manager

divh2Case Manager/h2pIntegrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing./ph3Job Description/h3pEducation Level: Masters/ppThis is a TEMP- TO-PERM Care Manager RN position. The position is created to meet and exceed the service level requirements to their customers./ppThese positions require a Masters Degree and a LCSW or LCPC license./ppCandidates need 2-3 years of Behavioral Health Experience, and 3-5 years of Utilization Management or Manager Care Experience. She is also looking for candidates with inpatient, outpatient, and behavioral health clinic experience./ppUnder general supervision, and in collaboration with other members of the clinical team, reviews utilization of mental health and substance abuse services provided in inpatient and intermediate care settings. Collects and analyzes utilization data. Assists with discharge planning and ambulatory follow up activity. Provides member assistance with mental health and substance abuse issues, and participates in special quality improvement projects. Monitors level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness.- Performs concurrent reviews for inpatient care and other levels of care as allowed by scope of practice and experience. In conjunction with providers and facilities, develops discharge plans and oversee their implementation.- Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria.- Interacts with Physician Advisors to discuss clinical and authorization questions and concerns regarding specific cases.- Participates in quality improvement activities, including data collection, tracking, and analysis Works with community agencies as appropriate. Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria. Advocates for the patient to ensure treatment needs are met. Interacts with providers in a professional, respectful manner that facilitates the treatment process./ppRequirements/Certifications:/ppStrong organization, time management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community resources and providers./ppKnowledge and experience in inpatient setting./ppKnowledge of DSM V or most current diagnostic edition. Ability to analyze specific utilization problems, plan and implement solutions that directly influence quality of care./ppCandidates need 2-3 years of Behavioral Health Experience, and 3-5 years of Utilization Management or Manager Care Experience./ppShe is also looking for candidates with inpatient, outpatient, and behavioral health clinic experience./ppThe manager will give preference to candidates located in the Alpharetta, GA area; however, she is open to remote candidates as well./ppThe Alpharetta, GA candidate will also have the ability to work remote./ppThis is an inbound telephonic position and the selected candidate will manager about 25 calls/day./ppThe majority of the calls are from providers and the other calls are from members and their family members./ppThe selected candidate will have 1-2 years of Managed Care/Clinical Review experience and 3-5 clinical experience./ppThere are 55 people on this team and it is divided into 3 clusters./ppThe training will be web based and it will be about 2-3 weeks long. The hours will be from 8am 5pm./ppThe selected candidate MUST be comfortable with navigating through multiple systems and comfortable with Outlook, Instant Messenger and Email./ph3Qualifications/h3pLCSW or LCPC license/ph3Additional Information/h3pRiya Khem/ppLife Science Recruiter/ppIntegrated Resources, Inc./ppIT Life Sciences Allied Healthcare CRO/ppCertified MBE |GSA - Schedule 66 I GSA - Schedule 621I/ppDIRECT # - View phone number on click.appcast.io | (W) # View phone number on click.appcast.io - Ext - 311 |(F) View phone number on click.appcast.io/p/div